Chapter 10 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 10  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. The nurse is providing care for an older adult man whose diagnosis of dementia has recently led to urinary incontinence. When planning this patient’s care, what intervention should the nurse avoid?

  1. A)  Scheduled toileting
  2. B)  Indwelling catheter
  3. C)  External condom catheter
  4. D)  Incontinence pads

Ans: B

Feedback:

Indwelling catheters are avoided if at all possible because of the high incidence of urinary tract infections with their use. Intermittent self-catheterization is an appropriate alternative for managing reflex incontinence, urinary retention, and overflow incontinence related to an overdistended bladder. External catheters (condom catheters) and leg bags to collect spontaneous voiding are useful for male patients with reflex or total incontinence. Incontinence pads should be used as a last resort because they only manage, rather than solve, the incontinence.

2. You are the nurse caring for a female patient who developed a pressure ulcer as a result of decreased mobility. The nurse on the shift before you has provided patient teaching about pressure ulcers and healing promotion. You assess that the patient has understood the teaching by observing what?

  1. A)  Patient performs range-of-motion exercises.
  2. B)  Patient avoids placing her body weight on the healing site.
  3. C)  Patient elevates her body parts that are susceptible to edema.
  4. D)  Patient demonstrates the technique for massaging the wound site.

Ans: B

Feedback:

The major goals of pressure ulcer treatment may include relief of pressure, improved mobility, improved sensory perception, improved tissue perfusion, improved nutritional status, minimized friction and shear forces, dry surfaces in contact with skin, and healing of pressure ulcer, if present. The other options do not demonstrate the achievement of the goal of the patient teaching.

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3. An elderly female patient who is bedridden is admitted to the unit because of a pressure ulcer that can no longer be treated in a community setting. During your assessment of the patient, you find that the ulcer extends into the muscle and bone. At what stage would document this ulcer?

  1. A)  I
  2. B)  II
  3. C)  III
  4. D)  IV

Ans: D

Feedback:

Stage III and IV pressure ulcers are characterized by extensive tissue damage. In addition to the interventions listed for stage I, these advanced draining, necrotic pressure ulcers must be cleaned (débrided) to create an area that will heal. Stage IV is an ulcer that extends to underlying muscle and bone. Stage III is an ulcer that extends into the subcutaneous tissue. With this type of ulcer, necrosis of tissue and infection may develop. Stage I is an area of erythema that does not blanch with pressure. Stage II involves a break in the skin that may drain.

4. A 74-year-old woman experienced a cerebrovascular accident 6 weeks ago and is currently receiving inpatient rehabilitation. You are coaching the patient to contract and relax her muscles while keeping her extremity in a fixed position. Which type of exercise is the patient performing?

  1. A)  Passive
  2. B)  Isometric
  3. C)  Resistive
  4. D)  Abduction

Ans: B

Feedback:

Isometric exercises are those in which there is alternating contraction and relaxation of a muscle while keeping the part in a fixed position. This exercise is performed by the patient. Passive exercises are carried out by the therapist or the nurse without assistance from the patient. Resistive exercises are carried out by the patient working against resistance produced by either manual or mechanical means. Abduction is movement of a part away from the midline of the body.

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5. An interdisciplinary team has been working collaboratively to improve the health outcomes of a young adult who suffered a spinal cord injury in a workplace accident. Which member of the rehabilitation team is the one who determines the final outcome of the process?

  1. A)  Most-responsible nurse
  2. B)  Patient
  3. C)  Patient’s family
  4. D)  Primary care physician

Ans: B

Feedback:

The patient is the key member of the rehabilitation team. He or she is the focus of the team effort and the one who determines the final outcomes of the process. The nurse, family, and doctor are part of the rehabilitation team but do not determine the final outcome.

6. A school nurse is providing health promotion teaching to a group of high school seniors. The nurse should highlight what salient risk factor for traumatic brain injury?

  1. A)  Substance abuse
  2. B)  Sports participation
  3. C)  Anger mismanagement
  4. D)  Lack of community resources

Ans: A

Feedback:

Of spinal cord injuries, 50% are related to substance abuse, and approximately 50% of all patients with traumatic brain injury were intoxicated at the time of injury. This association exceeds the significance of sports participation, anger mismanagement, or lack of community resources.

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